Secondary dental overpayment insurance put somebody through the mill?
my former primary dental insurance has a set contract rate of $433 for a root canal and they remunerated 80% which leaves a balance of less than $90. the dental bureau submitted my Explanation of benefits to my secondary insurance (at that time, but is now currently my primary) and they remunerated over $500 on that claim. I notified my former primary and they said that they will be requesting a refund to me since the dental bureau received appr. $400 profit since they are not allowed to take more than the contracted service fee and are contained by violation of their contract. so when i get this money fund from the endodontist should i give it back to my primary who be at the time my secondary or should i keep it for myself? i hope this wasn't too confusing. i hold already notified my secondary who is very soon my primary of the overpayment but they don't care and has cause me to max out due to the overpayment.
Answers:
The dentist,as far as I can see, did not violate his contract by accepting the secondary's erroneous payment. Obviously, the insurance made an error.The dentist's office will (if their billing dept is up to snuff) contact the insurance that compensated secondary (since they obviously rewarded incorrectly) and the secondary will request a refund, which the dentist will own to send once he gets the written request from the insurance co. Your dentist will not reimbursement anything directly to you...
Bank it but do not spend it. The ins. company will come looking for it Happen to me, two years later they wanted the overpayment and I contentedly sent it and kept the interest earned.
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Answers:
The dentist,as far as I can see, did not violate his contract by accepting the secondary's erroneous payment. Obviously, the insurance made an error.The dentist's office will (if their billing dept is up to snuff) contact the insurance that compensated secondary (since they obviously rewarded incorrectly) and the secondary will request a refund, which the dentist will own to send once he gets the written request from the insurance co. Your dentist will not reimbursement anything directly to you...
Bank it but do not spend it. The ins. company will come looking for it Happen to me, two years later they wanted the overpayment and I contentedly sent it and kept the interest earned.
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